There are more than 75,000 school-based SLPs in the United States, and we are working too hard. I identify as a glass-three-quarters-full person, and I can find the positives, the bright side and the out-of-the-box thinking. I thrive on this energy. As of late, it has been more effortful, and I am hearing you, SLPs. Recently, I met an SLP with a caseload of over 80 students across three campuses. He was the sole SLP for each of those campuses. I also met another SLP with a caseload of over 90 students across 6 campuses. This needs to change for the sake of our SLPs and our students. As a former school-based SLP, district and regional lead and current SLP serving in the trenches of two districts, I am deeply concerned.
6 Staffing Considerations for School-Based SLPs
Here are valuable considerations when staffing speech-language pathologists in a school:
1. Understand Workload versus Caseload:
Caseload is the number of students the SLP is serving. According to the ASHA Schools Survey 2016, the caseload mean is 51 students for an elementary school and 50 students for those working at the secondary level. “Workload” refers to all of our mandatory and performed activities, and the workload of school-based SLPs is astounding. Because there is not a general mandate for caseload, we need to understand workload. For more information, you can go the American Speech-Language-Hearing Association’s (ASHA) page on Workload vs. Caseload. Understand the workload of your hired SLPs before making campus placements.
2. Prime Duties:
Let’s take the previous point a bit further. The brilliant Tammy Qualls, my former district co-lead, developed a document that listed the Prime Duties of a speech-language pathologist. This list was distributed to district leads, and it provided a transparent (and enlightening) depiction of SLP responsibilities. Many assume that our role is primarily comprised of direct services. This is not the case. Here are the duties as defined by the scope of our school-based role:
- Providing direct speech-language therapy
- Participating in a Multi-Tiered System of Support (MTSS) (including Response to Intervention-RTI)
- Billing for Medicaid
- Conducting speech-language assessments
- Writing reports
- Planning, Facilitating and Following-Up with colleagues and families for IEP Meetings
It should be acknowledged that approximately half of SLP responsibilities are outside the scope of direct services, and time should be given for these tasks.
3. Pattern of Service Delivery:
There are many different ways to provide speech-language therapy, and, by law, we are mandated to provide an individualized schedule of services for students. This means there is not a specified time. We often hear 30-minutes twice a week as standard. Student needs should drive the schedule of service. Seeing a schedule where all 61 students receive 30 minutes of speech-language therapy weekly is a pattern of service delivery. Here is our course on Service-Delivery. Considerations for appropriate and individualized schedules should be taken into account when staffing SLPs.
4. Itinerant Considerations:
SLPs, oftentimes, share their time between multiple campuses. Understand that additional locations yield the following: added time for travel, differences in policies and procedures, rapport with staff, differences in availability of resources (including work space), specified days for IEP meetings, alignment of schedule for other itinerant staff members. Considerations for added locations for an SLP are necessary to ensure an understanding of his/her workload.
5. Evidence-Based Practice à Graduation:
Effective speech-language therapy requires individualization and time. When this happens, graduation from speech-language therapy can be attained. Time considerations for implementation of evidence-based strategies will yield quicker dismissals from speech.
6. SLP Happiness:
And, finally, SLPs do meaningful work. We empower students to use their words and voice to tell their stories. SLP effort is relevant and valuable. We should move forward with such consideration when staffing for our districts.
In closing, I will say that our work is important. When given the opportunities to do our job effectively, our students thrive. And, at the end of the day, we want our students and SLPs to thrive.